OTC painkillers - are we taking too many?

A study published in the journal Pharmacoepidemiology & Drug Safety in January found that people are taking too much ibuprofen.

Ibuprofen is part of a group of drugs known as NSAIDs (non-steroidal anti-inflammatory drugs). Another popular over-the-counter NSAID is naproxen. They are used generally to treat pain, often chronically. Another well known pain killer that is not an NSAID is acetaminophen, more popularly known by its brand name Tylenol (which is manufactured by the company that sponsored this study).

NSAIDs do have side effects, especially if the daily dose limit is exceeded. The drugs act to reduce inflammation, which has effects on blood pressure, the heart, liver, and kidneys. And it's important to follow dosing guidelines, as they've been established based on toxicity studies.

However, the study authors were quoted in the New York Post as recommending NSAIDs become prescription only, pushing acetaminophen as a safer option (though that drug has liver toxicity and a known history of being pulled from shelves). It's a bit of an extreme conclusion based on a single week of self-reporting and limited findings. For example, less than 10% of subjects recorded exceeding the dose with NSAIDs, and they also exceeded the dosing on other drugs they took in that same time period at near the same levels.

So maybe the conclusion should be that we need to communicate dosing better, or find better pain killers in general, rather than limit the availability of what currently works for people. And because of the conflicts of interest regarding the sponsorship of the work, this study just comes across as industry shill.

TEDTalk on what doctors don't know about pharma

Watch the original talk below and then read Ben Goldacre's followup at the Huffington Post.

Zithromax warning

The FDA has issued a warning for the use of azithromycin, an antibiotic sold under the brand name Zithromax. The agency warns that the drug may cause an irregular heart rhythm, potentially fatal in nature, in people with pre-existing risk factors, including QT prolongation, low blood potassium or magnesium, a slow heart rate, and arrythmia treated with medication.

Mad Cow Disease in California - UPDATED

Update: USDA's official press release is available here.

Earlier today Reuters and Bloomberg reported that U.S. officials had confirmed a case of Mad Cow Disease in a dairy cow at a rendering plant in California. It appears to be the first confirmed case in North America in a year (the last was Feb 2011 in Canada according to the CDC).

The USDA held a briefing on the matter and according to news outlets the cow did not enter the food supply - milk and beef in the U.S. is considered safe.

Women and the Affordable Care Act

As a woman who is self-employed I've found health insurance to be cost prohibitive. Many American women have run into the same issue, and we've seen in recent months that some of the basic hormonal treatments women use are misconstrued for various purposes (despite being required medication for some women). Women and health care appear to be at odds in the political sphere.

Though we can't fix all the problems women face with Congressional actions, the Affordable Care Act addressed some of the issues women have with insurance rates by regulating insurance companies in regards to not being able to deny women coverage and not being able to charge them more simply because they have particular anatomical features (i.e. a uterus, ovaries, and breasts). In 2014 these aspects of the law take effect (that is, if the Supreme Court doesn't overturn it).

Healthcare.gov outlines all of these features on their website.

The signed Affordable Care Act

Citrus fruit and stroke risk

By Figiu, Wikimedia

The Atlantic had an interesting article this month about citrus fruit and stroke risk. The article discusses a study showing that women benefit from flavanones in citrus fruit, protecting them against ischemic stroke, reducing their risk by 19 percent.

Flavanones are a specific flavonoid found in citrus, such as oranges and grapefruit. Other flavonoids are found in red win, dark chocolate, vegetables, and other fruits. However the results were specific to the subtype found in citrus. Previous research found that vitamin C is associated with a similar risk reduction.

Another caveat is that increasing fruit juice intake is not recommended - it's high in sugar. Best to just eat more fruit.

The data was from the Nurses Health Study. The idea that flavanones are healthy isn't new as research in 2005 sought to determine the mechanism underlying their antioxidant effect.

Differentiating between side effects and symptoms

A study published in Science Translational Medicine by researchers at Stanford describes a method for differentiating between a medication's side effects and the symptoms or signs of the illness or other issues. The analysis is statistical, but could open doors to understanding how to ensure patient safety.

FierceHealthIT offers a laymen synopsis of the study.